HomeMy WebLinkAboutRenewal Request 1.2/17/2015 13:33 9549773591 PERMIT PAGE 01/02
RECEIVE-0 BEC 18 2015
a jinN 11 PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
R U-ILDING AND CODE REGULATIONS DIVISION
2300 VIRGINIA AVE
• FORT PIERCE,FL 34982
(772)462-1553 fax(772)462-15?8
PERMIT RENEWAL REQUEST
PERMIT NUMBEX, SLC-150670199 ADDRESS, 3413 CRABAPPLE DR
Richard Levinson am requesting that the above permit be renewed. I
understand that i must schedule and pass all.recluiled inspections for the permit to be Finaled. Further,I
nderstand that this is a ONE TIS IIENEWAx,t and the permit shall expire should I not receive a
during the renewal period.
Ju ' zc ti We were unable to schedule with the meowner the inspection in the time alotted
rt e
OWN R OR CON CTOR SIGNATURE L-"QTF,
16—Ra—(a—Leli�aklllc)[-)
Print Name
STATE OF FLORIDA
COUNTY OF
ACKNOWLEDO� D BEFORE ME THIS_11 DAY OF 20
BY Lwn�,on WHO TS PERsONALJY KNOWN TO ME_,OR
HAS PROVIDED AS rDr--NTMJCA*nON,
oil in oil
STATE OF FLORIDA,,County SHERIFAWHM
MYCOMMSION#FF06M
OAIA W—f—G-U2EXPASS;October 21,2017
I ANRU (50NOTARSEAL
Y sandou 111ru Now/Po*Undamfta
FOR OFFICE IJSE ONLY:
Number of Open Inspections:—
Total Inspections:
(Divide open by total to get%of open inspections)
Percentage:
Original permit fee: X%open cz $ Renewal fee
Example: 115 divided by 23=.65(0/o)j S I 75(permit fee)x,0=S 113.75{renewal fec)
Rovind 7/21/2014